Exclusion from Employer?

I was wondering if there was any way to fight an exclusion from my husbands employer? When the company went from charging $8 a month for insurance to $80 a month. They told the employees that there would be no changes in the insurance. However when we went to meet with the bariatic coordinator we were told that there was now an exclusion in the policy per employer request. Someone said that there was help on Obesity.com, but I have been unsuccessful finding this. Could someone please help. Thanks, Stephanie

Hi Stephanie, Sorry you are going through this trouble. This is a good example of why you should get everything in writing. First, I would advise you to read your Summary Plan Description booklet and see if there is an exclusion for WLS or treatment for obesity. Then, I would have hubby email his HR benefit rep, and ask if there have been any ammendments, changes, or added exclusions to the plan since the printing date on the Summary Plan Description booklet. There is always a chance that the bariatric coordinator was given incorrect information. If not, at least you will know for sure. Best of luck, Roberta

Hi Stehanie and welcome to Obesityhelp.com, it really is a great place to get infomation and find wonderful people who know what you are going through. I am also new to all of this and I wanted to tell you that YES there is a way to fight an exclusion from your hubby's employer. I know this because I did it. Call the HR office and talk to everyone and anyone and find out who is in control of the benifits for the insurance. Talk to them and just tell them what is going on with you. Ask them if they are the ones that can get this overturned or if you need to talk to someone else. When you talk to the person who is can help you, tell them your story and don't ask them if they can overturn this exclusion, tell them you need to know what to do or what you need to send them for the company to overturn this. I know I had to call my doctor and have them fax over all my info. Then, I had to write a letter to the company telling them my story and asking them to please find it in there hearts to ovderturn this. I basically told them that with this surgery, it would slow down if not stop my medical problems. I told them that this obesity was killing me and my family. I told them I needed this not only for me but them too, they need me to be healthy as I can be. I don't know your story but I know that most of us are the same, in need of this help, for a better life. Just remember, don't be scared of the employer. Just tell them the facts and give it to God. I wish you the best. I know you can do this and I wish you luck. I know it can be done because it happend to me. By the way, if the employ. does approve you, GET IT IN WRITING! Make them fax you a letter of approval and that they are overturning this exclusion. If I were you, I would then call the insurance company and see who you needed to fax it to so you could get this thing on the road, and you fax it to them too. It will not hurt the insurance comp. to get a couple copies of the letter ! Good luck and please keep in touch or you can email me anytime. Welcome again to our family, please make yourself at home, you will find it is full of love and suport. Ps.46:10 "Be still, and know that I am God." Be blessed, Christina

Thank you all for your advice. We did contact the HR department and they said that they were only allowing people that had already received a precert. We were at the step before that. However I just started a new job, and if my insurance will allow the surgery and we list it as primary. My husbands employer has to cover the other half. As they are a self pay it will be coming out of their pocket. This was just another way for the company to screw their employees. They cut their last bonus check by $800 because the county declared a Snow emergency and they lost production for 1 day. They are not union so there are few ways to fight them. On a good note my husband and I had started the diet for before the surgery and he has lost 35lbs in 3 weeks. He is so excited he can not believe the scales. I on the othe hand lost 10 and gained 5. Thank you all for your support, care, and concern. Sincerely, Stephanie